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Texas 10 Step Program

The Texas Hospital Association and the Department of State Health Services collaborated to create the Texas 10 Step Facility Program, designed to improve the health of Texas mothers and infants by promoting breastfeeding. Since 2003,CHRISTUS Santa Rosa Hospital - New Braunfels has received the Texas 10 Step Facility Program certification. 

The ten steps are:

  1. Breastfeeding is the preferred method of newborn and infant feeding, and human milk is the optimum form of newborn and infant nutrition; all interventions and care plans should protect breastfeeding as a valuable resource.  This policy should be communicated to applicable staff upon employment and on an ongoing basis.
  2. Employees who care for newborns and infants should receive breastfeeding training within 6 months of employment, with updates provided on a regular basis.
  3. Staff should present breastfeeding as the feeding method of choice to all mothers.  Facilities offering prenatal classes should include information about the benefits and management of breastfeeding, and how mothers can maintain lactation even when separated from their newborns.
  4. Mothers and newborns are encouraged to breastfeed within 1 hour of birth, with 30 minutes being the ideal.  The policy should address alternations to this time frame for mothers delivering by Cesarean section or with complications.
  5. Mothers should be shown how to breastfeeding and maintain lactation, even if separated from their newborns.  Breastfeeding should be assessed within 6 hours of birth and once per shift.
  6. Newborns should be given supplementary formula only if specifically ordered by the physician for a clinical condition or upon parental request.
  7. Mother and newborns should be encouraged to remain together day and night, except for periods of up to 1 hours for medical procedures or if separation is medically indicated.
  8. Mothers should be encouraged to breastfeed their newborns without restriction.
  9. The use of artificial nipples and pacifiers should be discouraged for newborns without medical complications who are able to breastfeed.
  10. Mothers should have access to support for breastfeeding following discharge such as telephone follow-up, lactation visits, in-home visitation, telephone hotlines, mother-to-mother groups meetings and referral to community support groups.

Framed Texas 10 Step certificates are displayed in the hospital lobby as well as at the Birthing Center.